• Medicina intensiva · Mar 2018

    Observational Study

    Parathyroid hormone, calcidiol, calcitriol and adverse events in the acute coronary syndrome.

    • P Ramos Ruiz, L Jaulent Huertas, M Castañeda Sancirilo, J J Martínez Díaz, G Clavel Ruipérez, L García de Guadiana Romualdo, S Wasniewski, M Merelo Nicolás, I García Escribano, F Soria Arcos, J A Castillo Moreno, and L Consuegra Sánchez.
    • Servicio de Cardiología, Hospital Universitario de Santa Lucía, Santa Lucía, Cartagena, España.
    • Med Intensiva. 2018 Mar 1; 42 (2): 73-81.

    ObjectiveTo know the clinical profile as well as the prognostic significance of elevated levels of parathyroid hormone (PTH) in patients admitted for acute coronary syndrome (ACS).Design And SettingObservational and prospective study of patients admitted for ACS in a single Spanish center during a period of six months.Intervention And Variables Of InterestThe circulating concentrations of PTH, calcidiol, calcitriol, NT-proBNP, C-reactive protein, cystatinC and fibrinogen were determined within the first 48h at admission. We performed adjusted models to predict death or re-entry for ACS after hospital discharge.ResultsA total of 161 patients were recruited (age 67±14 years, 75.2% were men). Forty-one (25.5%) patients had elevated PTH values. During follow-up for a period of 275 person-years, 50 adverse events were recorded. Patients with elevated PTH levels were proportionally more women (21.2 vs. 39.0%) and older (63.3 vs. 77.8 years, both P<.05). Likewise, they presented significantly more cardiovascular risk and a worse prognosis during follow-up (incidence rate ratio 2.64 CI 95%: 1.5-4.6). However, in an adjusted model by the GRACE score, PTH levels were not shown to be an independent risk factor (hazard ratio=1.1; 95% CI: 0.6-2.2), neither other components of the panel.ConclusionsThe proportion of patients with elevated levels of PTH admitted for ACS was high. The presence of high PTH levels was associated with an unfavorable clinical profile and a worse outcome during the follow-up, although it was not an independent predictor of poor prognosis.Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

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